| Integrated Individual And Family Therapy, Llc | |
|
25 Day School Dr Middlefield CT 06455-1276 | |
| (475) 238-4509 | |
| Not Available |
| Full Name | Integrated Individual And Family Therapy, Llc |
|---|---|
| Speciality | Counselor |
| Location | 25 Day School Dr, Middlefield, Connecticut |
| Authorized Official Name and Position | Shazia Kareem (OWNER) |
| Authorized Official Contact | 4752384509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Individual And Family Therapy, Llc 25 Day School Dr Middlefield CT 06455-1276 Ph: (475) 238-4509 | Integrated Individual And Family Therapy, Llc 25 Day School Dr Middlefield CT 06455-1276 Ph: (475) 238-4509 |
| NPI Number | 1639521305 |
|---|---|
| Provider Enumeration Date | 07/06/2016 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Medicare PECOS PAC ID | 3577904754 |
|---|---|
| Medicare Enrollment ID | O20240520000589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639521305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Shazia Kareem |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477675056 PECOS PAC ID: 4486095668 Enrollment ID: I20240520000808 |
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